Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support
Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study wa...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1636 |
| _version_ | 1797470566124355584 |
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| author | Tommaso Pettenuzzo Chiara Giraudo Giulia Fichera Michele Della Paolera Martina Tocco Michael Weber Davide Gorgi Silvia Carlucci Federico Lionello Sara Lococo Annalisa Boscolo Alessandro De Cassai Laura Pasin Marco Rossato Andrea Vianello Roberto Vettor Nicolò Sella Paolo Navalesi |
| author_facet | Tommaso Pettenuzzo Chiara Giraudo Giulia Fichera Michele Della Paolera Martina Tocco Michael Weber Davide Gorgi Silvia Carlucci Federico Lionello Sara Lococo Annalisa Boscolo Alessandro De Cassai Laura Pasin Marco Rossato Andrea Vianello Roberto Vettor Nicolò Sella Paolo Navalesi |
| author_sort | Tommaso Pettenuzzo |
| collection | DOAJ |
| description | Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48–72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96–1.06) or escalation of treatment (OR 1.01, 95% CI 0.96–1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS. |
| first_indexed | 2024-03-09T19:38:00Z |
| format | Article |
| id | doaj.art-e23804be94a14e4e96262d4eef4bc141 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:38:00Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e23804be94a14e4e96262d4eef4bc1412023-11-24T01:49:48ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116163610.3390/jcm11061636Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory SupportTommaso Pettenuzzo0Chiara Giraudo1Giulia Fichera2Michele Della Paolera3Martina Tocco4Michael Weber5Davide Gorgi6Silvia Carlucci7Federico Lionello8Sara Lococo9Annalisa Boscolo10Alessandro De Cassai11Laura Pasin12Marco Rossato13Andrea Vianello14Roberto Vettor15Nicolò Sella16Paolo Navalesi17Institute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyInstitute of Radiology, Padua University Hospital, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyPediatric Radiology, Padua University Hospital, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyDepartment of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, 23 Spitalgasse, 1090 Vienna, AustriaInternal Medicine, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInternal Medicine, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyRespiratory Pathophysiology Division, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyRespiratory Pathophysiology Division, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyRespiratory Pathophysiology Division, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Department of Medicine, University of Padua, 2 Via Nicolò Giustiniani, 35128 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyInstitute of Anesthesiology and Intensive Care, Padua University Hospital, 13 Via Gallucci, 35121 Padua, ItalyForms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48–72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96–1.06) or escalation of treatment (OR 1.01, 95% CI 0.96–1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS.https://www.mdpi.com/2077-0383/11/6/1636chest X-raycoronavirus disease-19endotracheal intubationnoninvasive respiratory support |
| spellingShingle | Tommaso Pettenuzzo Chiara Giraudo Giulia Fichera Michele Della Paolera Martina Tocco Michael Weber Davide Gorgi Silvia Carlucci Federico Lionello Sara Lococo Annalisa Boscolo Alessandro De Cassai Laura Pasin Marco Rossato Andrea Vianello Roberto Vettor Nicolò Sella Paolo Navalesi Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support Journal of Clinical Medicine chest X-ray coronavirus disease-19 endotracheal intubation noninvasive respiratory support |
| title | Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support |
| title_full | Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support |
| title_fullStr | Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support |
| title_full_unstemmed | Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support |
| title_short | Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support |
| title_sort | chest x ray does not predict the risk of endotracheal intubation and escalation of treatment in covid 19 patients requiring noninvasive respiratory support |
| topic | chest X-ray coronavirus disease-19 endotracheal intubation noninvasive respiratory support |
| url | https://www.mdpi.com/2077-0383/11/6/1636 |
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